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Pegylated interferon α-2a versus standard interferon α-2a for treatment-naïve dialysis patients with chronic hepatitis C: a randomised study
  1. C-H Liu1,
  2. C-C Liang2,
  3. J-W Lin3,
  4. S-I Chen3,
  5. H-B Tsai4,
  6. C-S Chang4,
  7. P-H Hung5,
  8. J-H Kao6,
  9. C-J Liu1,7,
  10. M-Y Lai1,
  11. J-H Chen8,
  12. P-J Chen1,6,7,
  13. J-H Kao1,6,7,
  14. D-S Chen1
  1. 1
    Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  2. 2
    Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
  3. 3
    Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan
  4. 4
    Division of Nephrology, Department of Medical Affairs, St. Martin De Porres Hospital, Chia-Yi, Taiwan
  5. 5
    Department of Internal Medicine, Chiayi Christian Hospital, Chia-Yi, Taiwan
  6. 6
    Departments of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
  7. 7
    Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
  8. 8
    Department of Pathology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan
  1. Professor J-H Kao, Hepatitis Research Center, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan; kaojh{at}ntu.edu.tw

Abstract

Background: Chronic hepatitis C virus (HCV) infection is prevalent in dialysis patients, and standard interferon monotherapy is the current standard of care for such patients.

Aim: To investigate whether pegylated interferon has a better therapeutic efficacy and safety profile than standard interferon in dialysis patients with chronic hepatitis C.

Methods: 50 such patients were randomly assigned to receive either pegylated interferon α-2a 135 μg subcutaneously once per week or standard interferon α-2a 3 million units subcutaneously thrice per week for 24 weeks. The primary efficacy and safety end points were sustained virological response (SVR) by intention-to-treat analysis and treatment-related withdrawal rate during the study.

Results: In univariate analysis, patients receiving pegylated interferon α-2a tended to have a higher sustained virological response (SVR) than those receiving standard interferon α-2a (48% vs 20%, p = 0.07). By using multivariate analysis, treatment with pegylated interferon α-2a (p = 0.02) and pretreatment HCV RNA level <800 000 IU/ml (p = 0.007) were independently predictive of an SVR. All patients failing to achieve a rapid virological response (RVR) could not achieve an SVR. In addition, patients receiving pegylated interferon α-2a had a significantly lower treatment-related withdrawal rate than those receiving standard interferon α-2a (0% vs 20%, p = 0.04).

Conclusions: Pegylated interferon α-2a once weekly provides more effective and safer therapy than standard interferon α-2a thrice weekly for treatment-naïve dialysis patients with chronic hepatitis C.

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Footnotes

  • Funding: The study was supported by grants from the National Taiwan University Hospital, the National Science Council and Department of Health, Executive Yuan, Taiwan.

  • Competing interests: None.

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